Cervico–Vaginal Junction: The “North Star” of Total Laparoscopic Hysterectomy

Abstract

This article explores the crucial role of the cervico–vaginal junction (CVJ) for guiding total laparoscopic hysterectomy (TLH), drawing a parallel to the North Star's historical significance in navigation. The consistent polar position of the CVJ, its clear delineation by a colpotomy cup, and the CVJ's preservation throughout the TLH procedure make the CVJ an invaluable anatomical landmark for performing nearly all TLH steps—using this landmark is termed the CVJ-guided technique for TLH. This article describes the technique, which was developed by the lead author, and presents perioperative outcomes of 119 patients who underwent TLH using that technique. By utilizing this anatomical landmark, surgeons—beginners—can achieve mathematically precise and uniform performance of TLH steps, thereby enhancing their safety and reproducibility, (J GYNECOL SURG 40:161)